Should opioid addiction be considered a hospital-acquired condition?

Some medical experts and healthcare administrators are making the case that if an individual's addiction to opioids is directly rooted in hospital-based care, the hospital should be penalized, according to a recent report from NPR.

Such a policy could result in post-surgical opioid addiction being placed on the same tier of adverse outcomes as certain hospital-acquired infections.

Here are five things to know.

1. In a September Health Affairs blog, Michael Schlosser, MD, CMO for Nashville, Tenn.-based Hospital Corporation of America, along with two other physician executives, argued that hospitals should be on the hook for opioid addiction if the adverse outcome develops after care for a high-cost, high-volume condition that could have been prevented by adhering to evidence-based practices.

2. While the authors of the blog acknowledged it would be difficult for hospitals to monitor all patients prescribed opioids after surgery, they said hospitals should attempt to do so.

"Addressing long-term opioid use as a hospital-acquired condition will draw a clear line between appropriate and inappropriate use, and will empower hospitals to develop evidenced-based standards of care for managing post-operative pain adequately while also helping protect the patient from future harm," Dr. Schlosser told NPR via email.

3. The implementation of such a policy could conflict with current reimbursement practices that link patient satisfaction surveys to payment. However, portions of these surveys that address patient pain are moving away from questions that ask patients if their pain was adequately addressed in favor of questions that ask if providers communicated with the patient about their pain.

4. There are no firm federal guidelines for prescribing opioids post-surgery. While the CDC released opioid prescribing guidelines for chronic pain in 2016, the recommendations contain few references to acute pain. However, there is some emerging evidence that could eventually be used to frame opioid prescribing best practices for acute pain. One such study published in September in JAMA Surgery determined optimal post-surgical opioid prescriptions last between four and nine days.

5. Andrew Kolodny, MD, director of Physicians for Responsible Opioid Prescribing and co-director of the Opioid Policy Research Collaborative at Brandeis University's Heller School in Waltham, Mass., told NPR there are many physicians prescribing opioids without a firm grasp on what opioid withdrawal symptoms look like. Dr. Kolodny also said viewing post-surgical opioid addiction as a hospital-acquired condition is an idea worthy of consideration.

"We're in the midst of a severe opioid epidemic, caused by the over-prescribing of opioids," Dr. Kolodny told NPR. "Putting hospitals on the hook for the consequences of aggressive opioid prescribing makes sense to me."

Note: The headline of this article formerly said "hospital-acquired infection" and was corrected to "hospital-acquired condition" 11/28.